- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.06 / $36.57 / $59.20
| Professional | | $32.06 | $36.57 | $59.20 |
- Facility/Professional
- Professional
- Modifier
- 52
- Low / Median / High Price
- $16.03 / $17.77 / $29.60
| Professional | 52 | $16.03 | $17.77 | $29.60 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $35.54 / $43.62 / $61.44
| Professional | | $35.54 | $43.62 | $61.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.52 / $48.08 / $90.31
| Professional | | $32.52 | $48.08 | $90.31 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $29.27 / $46.98 / $109.02
| Professional | | $29.27 | $46.98 | $109.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $32.34 / $32.34 / $57.82
| Professional | | $32.34 | $32.34 | $57.82 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $38.68 / $52.29 / $83.35
| Professional | | $38.68 | $52.29 | $83.35 |